1689742777 NPI number — MRS. SHARON GUSTAFSON JONES R.N.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689742777 NPI number — MRS. SHARON GUSTAFSON JONES R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
SHARON
Provider Middle Name:
GUSTAFSON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARTINEZ
Provider Other First Name:
SHARON
Provider Other Middle Name:
GUSTAFSON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.N.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689742777
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6305 DRILL FIELD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTREVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20121-2311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-968-4007
Provider Business Mailing Address Fax Number:
703-263-1724

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14150 PARKEAST CIR
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
CHANTILLY
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20151-2295
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-968-4007
Provider Business Practice Location Address Fax Number:
703-263-1724
Provider Enumeration Date:
11/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WP0809X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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